Great @bmj_latest study from OpenSAFELY

Despite schools being the only thing open for much of wave 2 in the UK, living w/ children associated with marginal increased absolute risk of COVID-19 infection/hospitalisation, and no increase in death…

The study compared hospital records of over 9mil adults <65yrs during wave 1 and wave 2, comparing those who lived with children (split by primary and secondary age) to those who don't

They adjusted for covariates such as deprivation, age, BMI, smoking, etc

Wave 1: No difference in outcomes, except much lower risk of death for people with children

Wave 2: Tiny increase risk in infection and hospitalisation for those living with children (smaller for young children), but same or lower risk of death from COVID-19 or any cause.

The important factor here is that for a large proportion of wave 2, the whole country was in lockdown *except schools*

This means we could not have pushed much more of the risk of exposure on to schools if we had tried

Importantly, these types of studies are full of factors we can't account for

People with children will inherently behave differently to those without

Hence a similar study from Scotland found the opposite; living with children = lower risk!…

Does that mean these findings aren't useful? No.

It all fits with current evidence - putting children in school increases their exposure to COVID, which likely increases the household exposure

BUT - this equates to an amazingly small increase risk to family members

This is important in balancing out risks

The harms of NOT going to school are considerable

There are risks to sending kids to school, but fortunately they appears relatively low

Another piece to add to the puzzle


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More from @apsmunro

11 Mar
The #SARSCoV2 variant b.1.1.7 is taking over

But is this variant especially scary in children? ☠️

Are they suddenly driving infections? 🚗

Is this quadruple worrisome? 😱🚨⚠️

Let's take a look at the evidence

b.1.1.7 became of concern initially following a surge of cases in SE England after autumn lockdown

Case trends in children had previously lagged adults by a week or so (because adults drive infection rates), but this surge happened near simultaneously…

Some scientists leaked to the press of "hints" that there was something unique to children about this variant

This was based on an increased share of b.1.1.7 cases in children compared to adults during the late Autumn…

Read 16 tweets
18 Feb
I have seen some repeated assertions about the evidence on #COVID19, children and schools recently which sound convincing, but unfortunately are false

It is a sensitive and important topic, which is important to get right

Shall we bust some myths? 💥

Let's go!

Myth 1. Evidence suggesting limited transmission within schools is based on flawed evidence as only children with symptoms were tested ❌

There are many studies drawn on symptom based testing, there are MANY which are not, and all find the same thing

Here's just a few...

Read 12 tweets
5 Feb
You may have seen this headline today

It may even have been accompanied by scary emojis ⚠️ 🚨 💥 😱

The reality is much less scary (as is the article compared to the headline)

These numbers are roughly accurate, but do not reflect anything like a comparable scenario to spring

These children are MUCH less unwell, due to a combination of recognising less severe cases, early management, and perhaps a degree of over diagnosis to be on the safe side

Only a couple of patients per day are even unwell enough to be enrolled in the worlds only clinical trial for this condition, the RECOVERY trial

Very few cases of coronary artery aneurysms, which even after spring resolved for most children over follow up

Read 4 tweets
4 Feb
I don't put too much stock in ecological modelling studies, but I understand that some others do

A new study from the USA looks at which age groups appear to drive transmission trends

It has some interesting findings…

They use age specific mortality data to eliminate bias from undertesting of cases, alongside mobility and contact data

They found adults age 20 - 49 are the origins of most infections

This did not change over time, nor with school reopenings

"This study provides evidence that the resurgent COVID-19 epidemics in the US in 2020 have been driven by adults aged 20-49, and in particular adults aged 35-49, before and after school reopening."

Read 5 tweets
29 Jan
I've seen suggestions that the idea younger children might be less susceptible to infection with #COVID19 is a "myth", based on children just not being tested enough

That is untrue!

Whilst it's true children are under tested, this is not where this idea came from!

It comes from household contact tracing studies

When someone in a home is identified as being infected, the other members of the house are tested to see if they are infected

It's a useful experiment as everyone at home gets very similar exposure

Some early studies did only test contacts with symptoms, but actually most large studies since then have tested ALL close contacts REGARDLESS of symptoms

Here are just a handful




Read 8 tweets
9 Jan
I think people find it hard to understand the deal with kids reduced susceptibility to #COVID19 and what it means for schools etc

I thought I’d share a little analogy which helps me conceptualise it

Let’s imagine #COVID19 is rain... 🌧

Everyone wants to stop getting wet

Adults are just dressed normally 👦

Teens have a little hat on 🧢

Younger kids have got an umbrella ☂

When there is very little rain, you won’t notice much difference between how wet everyone is

When it starts raining a bit, you’ll notice the younger kids are less wet than adults

The teens may be just as wet as they spend more time out in the rain

Read 8 tweets

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